With Congress in the midst of discussing health care reform, Reuters provides us with results from a very timely study:
Medical bills are involved in more than 60 percent of U.S. personal bankruptcies, an increase of 50 percent in just six years, U.S. researchers reported on Thursday.
But the stunning result is that the bankruptcies come primarily from families with health insurance:
More than 75 percent of these bankrupt families had health insurance but still were overwhelmed by their medical debts, the team at Harvard Law School, Harvard Medical School and Ohio University reported in the American Journal of Medicine.
The study noted that it is not just the poor who are affected:
"Most medical debtors were well-educated, owned homes and had middle-class occupations."
A Harvard researcher and advocate for single-payer health care offers a perspective on these results:
"Unless you’re Warren Buffett, your family is just one serious illness away from bankruptcy," Harvard’s Dr. David Himmelstein, an advocate for a single-payer health insurance program for the United States, said in a statement.
"For middle-class Americans, health insurance offers little protection," he added.
These grim results are not just from a single study. Here is the abstract from a similar study from last year:
About 57 million Americans were in families with problems paying medical bills in 2007–an increase of 14 million people since 2003, according to a new national study by the Center for Studying Health System Change (HSC). Problems paying medical bills increased for both nonelderly insured and uninsured people. Although the rate of medical bill problems is much higher for uninsured people, most people with medical bill problems–42.5 million–had insurance coverage. About 2.2 million people with medical bill problems were in families that filed for bankruptcy as a result of their medical bills, and a much larger number reported other financial consequences, such as problems paying for other
When will Congress confront the fact that the health insurance industry exists to make money for itself, rather than to deliver health care? The Reuters article points out that many health insurance companies disappear just when they are needed most:
"Nationally, a quarter of firms cancel coverage immediately when an employee suffers a disabling illness; another quarter do so within a year," the report reads.
The solution? More from the article:
"We need to rethink health reform," Woolhandler said. "Covering the uninsured isn’t enough.
"Only single-payer national health insurance can make universal, comprehensive coverage affordable by saving the hundreds of billions we now waste on insurance overhead and bureaucracy."
Think of the health care that could be delivered by the hundreds of billions of dollars now going to health insurance fat cats and their bureaucracy. Call your Congressperson today to demand single-payer health care for everyone.
[It should be noted that the study in the Reuters article covers the years 2001-2007, ending before the worst of the real estate mortgage crisis.]
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Single payer national health care is the only way to go.
Now if I’m a layperson and I can figure that out, why is it that our full time paid reps are utterly clueless? Rhetorical question.
Thanks, Jim. I made note of this in a comment on scarecrow’s front-page post here, but it deserves ultra-widespread diarying and dissemination. As I noted in my comment, one of the coauthors is Elizabeth Warren of Harvard Law School, who currently serves as the congressional watchdog on the financial bailout.
The full text (pdf) of the published study in the American Journal of Medicine is available for free download here.
Thanks for that link. I spent a little time at the journal’s website and couldn’t find the paper. I see from the link that we have a pre-print, so the actual publication date isn’t known.
See, those who are happy with their current plan can keep it! Who is happy with their current plan?. Pure Fiction.
I saw some casual reference dropped a couple of days ago, I think by Howard Dean, alluding to poll data indicating that most people with employer-based insurance are happy with it.
Yeah, sounds like bullshit to me too, and I’d like to see the sampling and questioning methodology, if the poll even exists.
Of course, it’s easy to be happy with your health insurance until you need it.
One other study, also by coauthors Himmelstein and Woolhandler, was published this week, this time in a letter to New England Journal of Medicine. See the PNHP press release, Health, life insurers hold billions in tobacco stocks, which includes a link to the full-text letter.
Thanks for bringing this to a wider audience.
Seconded.
These absolutely key data points cannot be sufficiently emphasized.
To be honest, when I had insurance through either my employer or my (now ex-)husband’s, I was happy with it. My copays were no more than they are now with medicare and a medicare advantage plan, and when I needed surgery, I was not presented with any bill at all. So, yes, I believe that to be true; however, I also believe it is the luck of the draw. Some insurances from employers are not as good as mine.
thanks jim. great diary.
I have yet to have a really serious illness but the insurance documentation following my recent cataract surgery was a real eye-opener (accidental pun). Less typically opaque than usual it seemed to say that the four thousand dollar or so expense had just about exhausted my “in-house” portion for the year. My out-of-system limit of 7k is mostly intact but the percentage of coverage is lower than in-system. It seems to suggest that any ambulance ride I might have to take this year would have to go to a non-system hospital in order to get any coverage at all.
And since the hygienist left suddenly the long-deferred appointment I had to get my teeth cleaned was cancelled and it looks like I may have to get it done outside the DHMO’s list of preferred dental shops. The waiting list is already into October. Weren’t stories like these the staples of the anti-socialized medicine crowd once upon a time?
Here is an article in the LA Times that talks about Ron and me and our bankruptcy due to medical bills. The CBS Morning News called and we are taping this afternoon. They are going to interview us here in Sac. Makes me nervous but we decided to do it.
Ron and I filed for bankruptcy in 2003 due to medicals bills and then we both got sick again. We mortgaged our house three times to pay off hospitals, etc. We are getting divorced to indemnify ourselves from the other’s medical bills.
even with good insurance, there are still big problems with employer-based insurance.
a couple of examples:
* what happens if you are so sick that you lose your job?
* the cost to employers puts american manufacturing at a big disadvantage. for american workers in manufacturing industries, single payer could help keep them employed.
When one reaches the point of eligibility for medicare, that is to say, at the point in one’s life when medical care needs are paramount, for most people, one still has to obtain supplementary insurance to avoid having to pay any of the expenses incurred.
(((mary)))
bless you for what you are doing.
Wow!
I will believe it when it happens. They called us once before but nothing ever came of it.
Jim,ditto what Selise said. BUT “When will Congress confront the fact that the health insurance industry exists to make money for itself, rather than to deliver health care? can be answered by ‘when campaign contributions from corporations are not the vastly dominant funding for election campaigns.”
What I was overwhelmed by was the measures taken to settle the debts.
A really good way to make the point about the corrupt nature of health care is to talk about the patient outcomes in non-profit hospitals versus for profit hospitals. Guess who charges the most with the worst outcomes?
If it had happen more recently I don’t think I would have paid off the bills.
Nervous is normal, but you know your facts..somehow I don’t see an interviewer being able to sidetrack or confuse you..’g’. I’d guess the for profit hospitals?
Mary, all the best to you and Ron. Thank you for doing what you can to spread the story of how bad the current system is.
And even then, you still may have relatively high copays: my copay on a hospital stay of 8 days was $875. I also pay $40 for each visit to a specialist and $39/mo for each of 4 prescription drugs. My income is under $1,700/mo. That’s why I say relatively high copays.
CBS is sending a crew out to the house this afternoon. Looks like one of those times when I will put on makeup.
We’re pulling for you. I’m sure you will state the case very well.
jim – i’ve x-posted drsteveb’s diary from daily kos (thanks to ralphbon for the link). i’d emailed him earlier to ask (i actually asked him to x-post it here, and he replied that i could go ahead and do it). hope you don’t mind, figure this report can’t get too much attention.
Thank you, Mary! If there were any doubt as to the need for publicizing cases like yours, see this clip of a Fox News anchorbot interviewing Tim Carpenter of the Progressive Democrats of America about single payer. With the aid of industry advocacy groups (and following Frank Luntz’s playbook), Fox trotted out a Canadian woman who had a bad experience with her health care system and was compelled to seek care in the United States.
It is absolutely essential to drive home that for every cherry-picked single payer horror story the right wing whisks out from behind the curtain (and there is no such thing as a system that produces no horror stories) we have THOUSANDS of examples of people forced to choose between ruined health and ruined finances.
I am writing this down.
My other response that kind of statement is to say, “Perhaps the Canadian systems is not perfect. Can’t American do a better job? If we can see what is wrong with the Canadian system I am sure we will not reproduce it.”
That’s great. His diary has much more information that is very useful to all of us. Thanks for doing that.
As long as we’re cross-pollinating a bit with Daily Kos, I recommend checking out the nearly daily action diaries posted by former Congressional staffer slinkerwink, with phone numbers of key committee members.
Slinkerwink is tireless in exhorting readers to call these leaders, DAILY, to ensure that genuine health reform does not get horse-traded into oblivion. Her line in the sand is a Medicare-like public option — a notch or two to the right of mine — but she respects and encourages single payer advocates. And while she generally aligns herself with the HCAN playbook, she has no patience with the Schumer public option compromise, which HCAN (and even Dr. Dean, apparently) considers acceptable.
Great post Jim. Have spent the last year and a half in hospitals, nursing homes and assisted living facilities. Have met and talked with many seniors between the ages of 70-95. Many have used their life savings on their care after thinking that their insurance plans would take care of their needs.
Met one couple who divorced after 65 years of marriage so that he could get medicaid and she could stay in the family home. Pathetic
our seniors know how fucked up our health care system is. Sure wish Micheal Moore would do SICKO 2…3…4. Would really like to see one movie just focused on our seniors
The other day Scarecrow asked us to contact members of the congressional progressive caucus to make a plea for single payer as the dominant choice for health care reform.
As I’ve been following the HEALTHCARE-NOW communications, I recaptured the their list of sponsors of HR676 – a “unique American national universal health insurance Program. The bill would create a publicly financed, privately delivered healthcare system that uses the already existing Medicare program by expanding and improving to all US residents and all residents living in US territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective healthcare services regardless of their employment, income or healthcare status. With over 45-75 million uninsured Americans, and another 50 million are under-insured, the time has come to change our inefficient and costly fragmented non-helthcare system.
Rep. John Conyers is the primary sponsor of the bill.
In comparing the HR676 sponsors vs. the progressive list, I found 20 CPC members who are not co-sponsors of the Conyers’ bill.
The list can be found at http://www.healthcare-now.org/hr-676,
The following might be the priority of your contacts; they should be the prioritized list for phone/email contacts seeking support for single payer reform option. For the CPC list go to http://cpc.grijalva.house.gov/…..38;…
The latter ,list includes the following CPC members in the House and Senate:
Rep. Madeleine Z. Bondallo, Rep Andre Carson, Rep Peter DeFazio, Rep. Rosa DeLauro, Rep. Bob Filner, Rep. Marcia Fudge, Rep. Alan Grayson, Rep. John Hall, Rep. Phil Hare, Rep. Eddie Bernice Johson, Rep. Hank Johnson,Rep. Eleanor Homes_Norton, Rep. Charles Rangel, Rep. Linda Sanchez, Sen. Bernie Sander, Rep. John Serrano, Rep. Louise Slaughter, Rep. Pete Stark, Rep. Diane Watson, Rep. Mel Watt, Rep. Henry Waxman. (The sponsorship list shows the state affiliations of the sponsoring membersm while the CPC list does not.)
I’ve been unable to find anything beyond a general statment of general principles at Senator Kennedy’s site. Is there anything else available. Does he not yet have a sponsored bill ready. Is there a senate bill for
single payer focus?
Thanks for the post, Jim White.
Blessings to all,
Selise, don’t know why I indicated that the above was in response to you, unless it was to echo your thanks. I apologize.
Another resource on the issue is the AMA Physicans Working Groupfor Single-Payer National Health Insurance. See at http://www.pnhp.org. The proposal was published in JAMA (Journal of the American Association) in August 13, 2003!!! And consists of eight pages, which I haven’t read yet but plan to do so, as I plan to communicate with the 20 folks noted above.
Blessings to all
no problem!
p.s. i’m a BIG fan of pnhp. it was a physician-member who gave a talk on single payer (to a human rights group) in 2002 or 2003 that first opened my eyes and i remember reading that 2003 article when it first came out!
it has taken a long time (pnhp has been working on the issue for, i think, something like 20 years) to make the case and spread the word for single payer reform. no stopping now!
bernie sanders s.703 (bless him!). and more here from BargainCountertenor
also, from ralphbon:
that’s all i know of in the senate. maybe someone else has more?
Thank you so much Mary.
This is a huge fight.
What really gets me is even if you save money for COBRA it only lasts 18 months. It takes about 3 years to get onto medicare if disabled. See the problem here.
Also Medicare is an 80/20 plan. How are you going to pay 20% of your care if you are permanently disabled? I know my mom is having trouble because she has breast cancer. She can work a little but it is not that much money. If she was not married she would have a hard time making ends meet.
How is it that we have crafted a system that the sick and disabled are the ones least likely to get affordable care? What is wrong with us?
Hi, marchan. Bernie’s S.703 is the only single-payer bill in the Senate; there is no Senate verion of Conyers’s HR 676. Bernie’s bill (which does have a counterpart in the House, sponsored by Jim McDermott), focuses on state-instituted systems and is less desirable than the national health insurance outlined in HR 676. Bernie acknowledges those shortcomings; all things considered, he’d prefer an HR 676 system.
In addition to the comparison by Bargain Countertenor that selise links to, here’s a comparison from the Leadership Conference for Guaranteed Health Care web site. The Leadership Conference is the single payer coalition comprising PNHP, CNA/NNOC, and PDA.
cbs just left. We are going to be on The Early Show tomorrow morning.
Wow! Popcorn at 3am!
Will call again..thanks for the reminder
Of course the insurance companies intend to make money. That’s why they’re in business. If they didn’t make money, how would they be able to pay claims? OTOH, they have done a terrible job of controlling costs. The health industry including the pharmas have little interest in confronting unnecessary expenses. By requiring all sorts of billing for simple procedures, the costs rise. Few people question medical bills because they have no knowledge, only a desire for wellness.
Until costs are controlled, it makes little difference whether there is single payer or not. Just as in workers compensation, we need standard insurance policies and no fault payments. Require any insurance companies to meet standards and get approval for their rates.
With health costs reaching 1/6 of our GNP, we must admit there is no quick fix. But it is essential we accept that health insurance is an American right.
I have a friend who had a major surgery about 5 yrs ago(so things are even worse now.) He makes a decent income with no kids and is frugal with his money. He had copays for the specialist, tests and 3 overnight hospital stays before actual surgery, copay for each day he was in the hospital for the surgery(maxes out after 5 days.) Total out of pocket cost for him with decent health insurance -$4400. He was lucky he had the funds but if you are making under $50K with a couple of kids I’m not sure $4400 wouldn’t drive you over the cliff financially. I know a bunch of people who work at low paying jobs who have insurance offered at work but can’t afford it because they don’t make enough money for the employee share of the premium. My own dad couldn’t get insurance once he let it lapse because he was having financial problems. At stupid as it may sound, my dad was an immigrant who figured that surely this country would have laws that would not allow insurance cos. to not just totally not cover you. And BTW, I believe he died earlier than he would of medical care he did not recieve when he was in his early sixties before he went on medicare, not to mention the stress of worrying about if you are going to lose everything if some medical emergency occurs. I really would like to pull whatever health insurance Max Baucus and Ben Nelson have and let them head out there and find insurance.
Thanks so much to Selise and Ralphbon for the followup; have printed up your cites and will add them to the reading list. You all amaze me with your knowledge. Bless you.
One of the points covered in one of the posts and discussions was money to educate medical support personnel. To which I say hooray, but I wish I could write in further education for doctors as well. And I want to share my personal stance on the health care system.
I some 20 million Americans have a neurological condition known as peripheral neuropathy (PN. The American doctor and supporting professionals know very little about this complex disease condition that has some 100 types of manifestation and some 200 causes, including some commonly prescribed medications. Most will think that only diabetics have PN (they do constitute about one-third of all PNers)and if their PNer patients aren’t diabetic they don’t know what to do as they’re not trained in that and other forms of PN; nor are they trained on how to treat it, regardless of cause and will pretty automatically prescribe neurontin with varying degrees of dosages – 300 to 3600 mg per day; which will help some in reducing some symptoms. And PN symptoms will vary over time and in relation to the cause(s) of the neuropathy, but most docs won’t know that. Nor will they know about lots of other alternative treatments that could really better help with the symptoms; they’re unknown because they aren’t owned and pushed by big Pharma.
When people talk about the best practices research and service limitations in the stimulus package and healthcare reform writings, I get real concerned because know that Big Pharma will dominate the determinations of what works and will be paid for. The complimentary/alternative medical
lobby is too small and weak to demand a seat at the table and assurance or their perspectives be included, despite the NIH sponsored CAM research and treatment recommendations.
I’ve been involved in a Northern California regional network of support groups for the last several years, leading groups, writing and publishing a monthly newsletter filled with all kinds of PN news, etc., advocating for better medical care with doctors, doing public education health fairs providing lots of PN info, and organized a unique public awareness project in which we had eyecatching posters on all the buses in the three county Sacramento metro area with a cartoon depiction of the most common symptoms, along with a list, a phone number to call for more information, etc.
I’ve been the voice for the neuropathy hotline for almost two years
and I’ve learned a great deal about the paucity of competent treatment for those PNers who ride buses, whether they are middle class public transit commuters, lower income and homeless folks. Hundreds, maybe thousands have seen the posters, many have recognized the symptons as like their own.
Suddently they have a name and know they’re not crazy. Many have called and their stories have broken my heart. Sometimes I have tried to intervene with the public health clinics they may have access to. If they don’t have medical care, I send brochures about area clinics to which they might go and a brochure from the Health Rights Hotline on how they can get help with their provider problems. I’ve always sent a sizeable Neuropathy 101 package of information and a list of area support groups they might attend – even knowing that most of whose locations aren’t accessible by bus, etc.
What I know from talking with these folks and solidly middle class folks
who come to support group meetings or otherwise get to me, is that none of us are getting really competent care for our conditions because of very limited doctor/nurse training on neurological conditions and pain management strategies, even all doctors are supposedly required to attend yearly (?) workshops on this.
What I know from these encounters is that we desperately need secure, competent, comprehensive medical care in our issues. What I know is that it rarely exists and most doctors haven’t a clue to what we’re experiencing and we are totally discounted and denied appropriate diagnostic procedures and treatment options for our chronic conditions. (I forgot to mention that there is no cure for “99%” of our neuropathies.) I find this to be generally true regardless of the public and/or private sources of our medical care.
Part of our problem is that most of us are “older” (although PN can occur at all ages, depending on the type/cause) and we tend to be discounted by most doctors, most of whom still say that little is know about neuropathies. That once was true, but it no longer is, there is tons of information available in medical textbooks, patient-centered books, and the internet. As we learn, we begin to educate oen another and our doctors.
So regardless of whatever the final general shape and particulars are to be in the new legislation, I hope to God that the kinds of concerns I’ve outlined above will find some resolution. But I am thoroughly convinced that the best prospect is single payer systems and a strong PN advocacy community fighting for improved services for us.
Sometimes I’ve wished that I’d had cancer or some other more commonly known condition. Maybe then I and others with neuropathy would have gotten better care.
Bastante. Thanks again for FDL’s coverage of the healthcare reform issue in remarkable depth and breadth.
Blessings to all,
Thank you for all of your hard work and for sharing very useful information with us.
You are a blessing to those in need.
Let me lead into this by saying I’m a huge proponent of a Canadian style system. I believe we are long past the point where simple insurance can meet peoples healthcare needs; it’s not financially possible anymore.
Now, what I’m getting from people who are against any kind of single-payer plan is this comment from Megan McCardle about the bankruptcy study:
**
What’s left out here? That in 2001, 1.45 million households filed for bankruptcy. In 2007, that number was 727,167. Had their paper done the basic arithmetic, readers would easily have seen that their own numbers imply a decrease in medical bankruptcies, from about 750,000 to slightly over 500,000. Yet their paper does not merely ignore this fact; it uses language that seems deliberately designed to conceal it. I invite any of my readers to scan the paper for any hint that medical bankruptcies had fallen significantly over 6 years.
This is elementary social science. A huge change in the composition of your sample needs to be noted. It certainly should not be artfully disguised. If the 2005 bankruptcy form made it more difficult to file bankruptcy, the people who still file bankruptcy will largely be those who are forced to it by events totally beyond their control. Medical bankruptcies seem to fill that bill.
Yet even so, their own work shows medical bankruptcies falling in the years between 2001 and 2007, which would seem to invalidate, not support, the claim that half of all bankruptcies in 2001 were driven by medical events beyond the household’s control.
http://meganmcardle.theatlanti….._terri.php
And I pose this question: Is she right?
McArdle’s getting ripped to shreds in the comments to her post. Key points:
– The authors of the study never said that total personal bankruptcies have increased since 2001. (McArdle claims they imply this.) They explicitly document an increase in the percentage of personal bankruptcies attributable to medical bills.
– Of course total personal bankruptcies fell between 2001 and 2007, in part because of
1. the little business of the 2005 bankruptcy bill, specifically designed to make it harder for consumers to file Chapter 7, and
2. the fact that 2001 to 2007 arbitrarily demarcates the period from the DotCom Bust to the height of the mortgage-backed boom.